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Gastric peroral endoscopic myotomy versus surgical pyloromyotomy/pyloroplasty for refractory gastroparesis: systematic review and meta-analysis

Background and study aims  Gastric per-oral endoscopic myotomy (G-POEM) has been recently compared with surgical techniques (i. e. pyloromyotomy and pyloroplasty) for managing patients with refractory gastroparesis. Given the varying results, we performed a systematic review and meta-analysis of ava...

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Autores principales: Aziz, Muhammad, Gangwani, Manesh Kumar, Haghbin, Hossein, Dahiya, Dushyant Singh, Sohail, Amir Humza, Kamal, Faisal, Lee-Smith, Wade, Adler, Douglas G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2023
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10072926/
https://www.ncbi.nlm.nih.gov/pubmed/37025156
http://dx.doi.org/10.1055/a-1980-9942
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author Aziz, Muhammad
Gangwani, Manesh Kumar
Haghbin, Hossein
Dahiya, Dushyant Singh
Sohail, Amir Humza
Kamal, Faisal
Lee-Smith, Wade
Adler, Douglas G.
author_facet Aziz, Muhammad
Gangwani, Manesh Kumar
Haghbin, Hossein
Dahiya, Dushyant Singh
Sohail, Amir Humza
Kamal, Faisal
Lee-Smith, Wade
Adler, Douglas G.
author_sort Aziz, Muhammad
collection PubMed
description Background and study aims  Gastric per-oral endoscopic myotomy (G-POEM) has been recently compared with surgical techniques (i. e. pyloromyotomy and pyloroplasty) for managing patients with refractory gastroparesis. Given the varying results, we performed a systematic review and meta-analysis of available studies to assess the safety and efficacy of each technique. Patients and methods  A comprehensive review of the literature using the following databases was undertaken through July 29, 2022: MEDLINE, Embase, Web of Science, KCI – Koran Journal index, Global Index Medicus, and Cochrane. Comparative studies including case-control, cohort and randomized controlled trials (RCTs) were included. Random effects model using DerSimonian laird approach was used to compare outcomes. Relative risk (RR) and mean difference (MD) were calculated for binary and continuous outcomes respectively. Results  A total of four studies with 385 patients (216 in the G-POEM group and 169 in the surgical group were included. The mean age was 46.9 (± 3.41) and 46.2 (± 0.86) and the female proportion was 79.6 % and 74.0 % for the G-POEM and surgery group respectively. The mean procedural time (MD: –59.47 mins, P  < 0.001) and length of hospital stay (MD: –3.10 days, P  < 0.001) was significantly lower for G-POEM compared to surgery. The post procedure GCSI score (MD: –0.33, P  = 0.39) and reduction in GCSI score preoperatively and postoperatively (MD: 0.27, P  = 0.55) was not significantly different. Conclusions  G-POEM appears promising as it may provide a cost-effective approach for managing refractory gastroparesis compared to surgical techniques. RCTs are needed to further confirm these results.
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spelling pubmed-100729262023-04-05 Gastric peroral endoscopic myotomy versus surgical pyloromyotomy/pyloroplasty for refractory gastroparesis: systematic review and meta-analysis Aziz, Muhammad Gangwani, Manesh Kumar Haghbin, Hossein Dahiya, Dushyant Singh Sohail, Amir Humza Kamal, Faisal Lee-Smith, Wade Adler, Douglas G. Endosc Int Open Background and study aims  Gastric per-oral endoscopic myotomy (G-POEM) has been recently compared with surgical techniques (i. e. pyloromyotomy and pyloroplasty) for managing patients with refractory gastroparesis. Given the varying results, we performed a systematic review and meta-analysis of available studies to assess the safety and efficacy of each technique. Patients and methods  A comprehensive review of the literature using the following databases was undertaken through July 29, 2022: MEDLINE, Embase, Web of Science, KCI – Koran Journal index, Global Index Medicus, and Cochrane. Comparative studies including case-control, cohort and randomized controlled trials (RCTs) were included. Random effects model using DerSimonian laird approach was used to compare outcomes. Relative risk (RR) and mean difference (MD) were calculated for binary and continuous outcomes respectively. Results  A total of four studies with 385 patients (216 in the G-POEM group and 169 in the surgical group were included. The mean age was 46.9 (± 3.41) and 46.2 (± 0.86) and the female proportion was 79.6 % and 74.0 % for the G-POEM and surgery group respectively. The mean procedural time (MD: –59.47 mins, P  < 0.001) and length of hospital stay (MD: –3.10 days, P  < 0.001) was significantly lower for G-POEM compared to surgery. The post procedure GCSI score (MD: –0.33, P  = 0.39) and reduction in GCSI score preoperatively and postoperatively (MD: 0.27, P  = 0.55) was not significantly different. Conclusions  G-POEM appears promising as it may provide a cost-effective approach for managing refractory gastroparesis compared to surgical techniques. RCTs are needed to further confirm these results. Georg Thieme Verlag KG 2023-04-04 /pmc/articles/PMC10072926/ /pubmed/37025156 http://dx.doi.org/10.1055/a-1980-9942 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Aziz, Muhammad
Gangwani, Manesh Kumar
Haghbin, Hossein
Dahiya, Dushyant Singh
Sohail, Amir Humza
Kamal, Faisal
Lee-Smith, Wade
Adler, Douglas G.
Gastric peroral endoscopic myotomy versus surgical pyloromyotomy/pyloroplasty for refractory gastroparesis: systematic review and meta-analysis
title Gastric peroral endoscopic myotomy versus surgical pyloromyotomy/pyloroplasty for refractory gastroparesis: systematic review and meta-analysis
title_full Gastric peroral endoscopic myotomy versus surgical pyloromyotomy/pyloroplasty for refractory gastroparesis: systematic review and meta-analysis
title_fullStr Gastric peroral endoscopic myotomy versus surgical pyloromyotomy/pyloroplasty for refractory gastroparesis: systematic review and meta-analysis
title_full_unstemmed Gastric peroral endoscopic myotomy versus surgical pyloromyotomy/pyloroplasty for refractory gastroparesis: systematic review and meta-analysis
title_short Gastric peroral endoscopic myotomy versus surgical pyloromyotomy/pyloroplasty for refractory gastroparesis: systematic review and meta-analysis
title_sort gastric peroral endoscopic myotomy versus surgical pyloromyotomy/pyloroplasty for refractory gastroparesis: systematic review and meta-analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10072926/
https://www.ncbi.nlm.nih.gov/pubmed/37025156
http://dx.doi.org/10.1055/a-1980-9942
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